Size begets financial strength, which begets adoption of health information technology, according to a survey of about 560 physician practices conducted by the Medical Group Management Association and released at the group's national convention in San Francisco.
The survey, taken in May and June, found that 25% of respondents reported lack of capital as a barrier to implementing electronic health records. Another 9% cited insufficient return on investment as a limiting factor.
Respondents with three or fewer full-time equivalent physicians reported a 20% adoption rate of EHRs, compared with a 41% adoption rate by groups of 26 physician FTEs or more.
"More capital, more sophistication, more application," explained David Gans, director of practice management resources of MGMA, the Englewood, Colo., not-for-profit group, which conducted the study under contract with the federally funded Agency for Healthcare Research and Quality.
Gans said it was left to each respondent to define what constituted an electronic health record system and that some people "have a more generous interpretation" of what an EHR is, which may have inflated he adoption numbers.
On certain key functions of a clinical IT system, the percentages were lower than for having a system overall. For example, 20% of respondents said their systems could write prescriptions, 10% said they had a patient disease registry, and another 10% said their systems had clinical decision support capabilities.
The MGMA survey numbers for EHR penetration compare closely with those released last month by the Washington, D.C.-based Center for Studying Health System Change, which concluded, based on 2001 survey data, that physician adoption of IT systems remains low. Fewer than 25% of physicians could generate electronic patient reminders, and 10% could write electronic prescriptions, according to HSC.
William Jessee, M.D., MGMA president and chief executive officer, said that the survey indicates a higher rate of EHR adoption than was shown on a member survey a couple of years ago.
"While there are still a lot of barriers to adoption, the rate is going up," Jessee said. "We may well be seeing us getting close to a tipping point on EHR adoption."
Gans said the MGMA plans a more comprehensive survey on IT usage in November.